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hi there today Iamp;#39;ll be discussing left bundle branch blocks and how to apply the garbosa criteria as required by the UC Davis School of Medicine I have no Financial disclosures before we begin I would like to acknowledge Tom buhay a paramedic firefighter Captain with the Hilton Head Island fire rescue Department he is the editor of the ems2 leaf blog and without his help I donamp;#39;t donamp;#39;t think I would ever know about the scosa criteria and be pretty ignorant about this entire subject altogether so thank you Tom so letamp;#39;s begin with some normal Anatomy this is a picture of the hearts electrical conduction system a normal heartbeat will start in the essay node travel down the internodal pathways Poe slightly in the AV node then go down the left and right bundle branches through the bundle of His to depolarize the right and left ventricle in left bundle branch blck Anatomy we see that the left bundle branch is affected by a blockage this can be caused by acute